Soft tissue sarcoma - Australian Sarcoma Group

1 soft tissue sarcomaFor people with cancer, their family and friendsSponsored byThis fact sheet is for people with soft tissue Sarcoma who would like to know more about their cancer and its treatment. It describes the types, causes and symptoms of soft tissue Sarcoma as well as treatments and their possible side effects. This does not replace talking to your doctors or nurses. However, we hope that it will help you make decisions with your doctor about your is soft tissue Sarcoma ? soft tissue is the name for all the supporting tissues in the body, apart from the bones. They include fat, muscle, nerves, deep skin tissue , blood vessels and the tissue that surrounds joints (synovial). These tissues support and connect all the organs and structures of the body.

2 They are known as connective tissue . A soft tissue Sarcoma is a rare type of cancer that forms as a painless lump (tumour) in any one of these soft tissues. They most commonly develop in the thigh, shoulder and pelvis. Sometimes they can grow in the abdomen or chest (trunk).Types of soft tissue sarcomaThere are over 70 types. These are named after the abnormal tissue cells that make up the Sarcoma . The most common type is malignant fibrous histiocytoma (MFH), which is made up of millions of abnormal spindle shaped cells. Liposarcoma is the next most common type of soft tissue Sarcoma ; it is made up of millions of abnormal fat cells. Others include:leiomyosarcoma and rhabdomyosarcoma, from muscle tissues angiosarcoma, from blood vesselsEwing s Sarcoma and PNET (primitive neuroectodermal tumour) MPNST: malignant peripheral nerve sheath tumour (PNST) GIST: gastrointestinal stromal Sarcoma (this is treated differently from other types of soft tissue Sarcoma ) stromal Sarcoma from supporting tissues Kaposi s Sarcoma of the skinsynovial Sarcoma .

3 How common is soft tissue Sarcoma ? soft tissue Sarcoma is not common. Around 330 Victorians develop one of these cancers each year. soft tissue Sarcoma can develop at any age. Although it is more likely to happen in people over the age of 55, young adults may also be affected. There is almost an equal risk for males and females. What causes soft tissue Sarcoma ?The causes of most sarcomas are not known. There are several risk factors. soft tissue sarcomaFor people with cancer, their family and friendsPrevious treatment with radiotherapyThere is a very small risk for people who have had radiotherapy. The risk is higher for people who had high doses of radiotherapy at a very young age. Most people who have had radiotherapy in the past will not develop a Sarcoma .

4 Genetic factorsSome rare, inherited conditions can put people at more risk of soft tissue Sarcoma . These are:Von Recklinghausen disease (neurofibromatosis): non-cancerous lumps that develop in the nerves under the skin and over time can turn into syndrome: a genetic condition that increases the risk of many cancers in one family, including soft tissue : a rare type of eye cancer mainly found in people know if these very rare conditions run in their family and that they may pass it to their small number of people develop Sarcoma due to genetic changes that happen during their lifetime, rather than inheriting a faulty are the symptoms of soft tissue Sarcoma ? Sarcoma usually doesn t cause symptoms in its early stages. As it grows over a period of months, you may develop a painless lump.

5 You may begin to have pain as the lump grows and presses on nerves and muscles. Other symptoms will depend on where in the body the Sarcoma is. Sometimes a soft tissue Sarcoma may be mistaken for a benign fatty lump (lipoma) or bruise (haematoma). This can delay tests that would help make the right diagnosis. Most people who develop a painless lump do not have a Sarcoma . It is much more likely to be a less serious condition. However, if you have symptoms that persist for more than two weeks you should see your doctor. How is Sarcoma diagnosed?If your doctor thinks that you may have a soft tissue Sarcoma they will carry out blood tests, x-rays and scans. If the results suggest that you may have a Sarcoma , your doctor will refer you to a specialist centre where experts in the care of your cancer will help to look after your treatment.

6 You may need to have a biopsy. This is the only sure way to diagnose a soft tissue Sarcoma but the other tests are needed first to rule out other conditions. A biopsy means taking a sample of cells from the lump and examining them under a microscope. Your doctor will use a fine needle to do this. You will have local anaesthetic to numb the area before the needle is put into the lump. A tissue biopsy is a specialised procedure. It should only be carried out by a specialist who does them regularly. It is important that the biopsy is done properly in order to minimise the chance of the cancer spreading. It could also affect the type of treatment that you may be able to have. soft tissue sarcomaFor people with cancer, their family and friendsTreatment of soft tissue sarcomaYour doctor will help you decide on the best treatment for your Sarcoma depending on:the type of Sarcoma that you havewhere the Sarcoma is in your bodywhether or not the cancer has spread (its stage)your age, fitness and general healthwhat you may include surgery, chemotherapy and radiotherapy.

7 They can be given alone or in combination. SurgerySurgery is the main treatment for most types of soft tissue Sarcoma . This usually means removing the cancer as well as some healthy tissue around the tumour. Doctors call this a wide local excision. The healthy tissue is taken away to help decrease the risk of the cancer coming back in that area. The type of operation you will have will depend on where the Sarcoma is. Most sarcomas are in the arm or leg, which usually means having limb sparing surgery, or less commonly amputation. But sarcomas can develop in other parts of the body, for example the chest or abdomen. Surgery to these areas will depend on the exact position and size of the tumour. Your surgeon will discuss with you the type of operation you may need.

8 The most important thing is that you have your surgery done by an experienced surgeon working in a specialist centre for sarcomas . Plastic surgeons are sometimes asked to work with surgeons to restore someone s body as best as possible to its original state. This would be part of your main operation. The type of surgery you have will depend on the location of the Sarcoma and how much tissue needs to be removed. Before you make any decision about treatment, your surgeon will discuss all your options in detail. Surgery for Sarcoma that has spread to the lungsSometimes Sarcoma spreads into the lungs. Unlike some other types of cancers, Sarcoma lung tumours can sometimes be taken out using surgery. This depends on the size and number of tumours.

9 You will see a specialist lung surgeon for an opinion. Alternatively, or as well as surgery, you may have chemotherapy to help stop the cancer coming sparing surgeryThis means cutting out the cancer as well as a margin of healthy tissue while still keeping your limb. If necessary, bones may be rebuilt using a metal implant (prosthesis) or a bone graft. A graft means taking a piece of healthy bone from somewhere else in your body or from a bone bank . Any other gaps in the tissue are usually reconstructed using plastic this type of surgery you will work closely with a physiotherapist. They will plan an exercise program to help you gain strength and function back in your limb. There will be some changes in the way the soft tissue sarcomaFor people with cancer, their family and friendslimb, looks, feels or functions after limb sparing surgery.

10 But the aim is for your limb to return to as normal a state as possible. This complex surgery needs to be done by a surgeon with a lot of experience in treating Sarcoma . This may mean that you have to travel to a treatment centre that has a team of experts. Surgery done well may decrease the risk of the tumour cells spreading to nearby areas or other parts of the body. AmputationThis is only done occasionally when it is not possible to cut out a Sarcoma and leave the person with an arm or leg that works. Sometimes it is not possible to remove all of the cancer without badly affecting the arm or leg. The doctor may advise that the only effective treatment will be to remove the limb (amputation). Amputation can be very distressing emotionally and physically.